Analyst II - Regulatory Affairs (hybrid)

Inland Empire Health Plan; Rancho Cucamonga (CA); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Competitive salary

State of the art fitness center on‑sit

Medical Insurance with Dental and V is

Life, short-term, and long-term(dis)

Career advancement opportunities and专业

Wellness programs that promote a健康工作生活

Flexible Spending Account – HealthCare

CalPERS retirement

457(b) option with a contribution

Paid life insurance for employees

Pet care insurance

Job summary

Inland Empire Health Plan (IEHP) in Rancho Cucamonga, CA, invites you to join our Regulatory Affairs team as Analyst II. You will manage centralized regulatory activities to ensure compliance with CMS, DHCS, DMHC, and Covered California, contributing to high-quality health plan operations.

You’ll collaborate with internal teams and regulatory agencies, support quality initiatives like HEDIS and NCQA accreditation, and help implement state and federal requirements while maintaining IEHP’s

Qualifications

• Two years of experience with managed care or other relevant industry experience.
• Experience in health care, health plans, Covered California, Medicaid MCPs, Medicare Advantage, SNPs, and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
• Experience interacting with regulatory agencies.
• Knowledge of state and Federal regulatory requirements and practices related to Covered California, Medicare, and Medi-Cal (Medicaid).
• Bachelor's degree from an accredited institution required.

Responsibilities

• Perform centralized regulatory activities for the Compliance Department.
• Ensure Plan operations, processes, procedures, policies comply with CMS, DMHC, DMHC and Covered California.
• Interact with regulatory agencies to support compliance.
• Support IEHP Quality Program goals (HEDIS, CAHPS, NCQA Accreditation) and regulatory documentation.

Skills

Regulatory knowledge

Interpersonal skills

Communication skills

Project management

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office

Job description

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!

Under the direction of the Manager, Regulatory Affairs, the Analyst II, Regulatory Affairs has experience with and performs key centralized complex and difficult regulatory activities for the Compliance Department. Team Members in this position ensure Plan operations, processes, procedures, policies, etc. are in compliance with regulatory agencies, including but not limited to, Covered California, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC).

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Education & Requirements

• Two (2) years of experience with managed care or other relevant industry experience
• Experience in health care, health plans, Covered California, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect
• Experience interacting with regulatory agencies
• Knowledge of and experience with state and Federal regulatory and other requirements and practices related to Covered California, Medicare and Medi-Cal (Medicaid), Title 19 (USC)/Title 29 (USC and CCR), Title 22 (CCR), Title 28 (CCR), Title 42 (USC and CFR), CA Welfare and Institutions Code, and CA Health and Safety Code
• Bachelor's degree from an accredited institution required

Key Qualifications

• Must have a valid California Driver’s license and valid automobile insurance
• Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
• Knowledge of Principles and practices of managed care
• Possess strong interpersonal and presentation skills to communicate with internal departments and external agencies
• Clearly and effectively convey project objectives
• Strong organizational skills and attention to detail
• Effective communication skills; verbal and written
• Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, Outlook, and Access
• Ability to apply knowledge and address situations appropriately without extensive guidance
• Demonstrated ability to establish relationships of trust and respect with Team Members at all levels
• Ability to manage multiple projects with competing deadlines and changing priorities
• Ability to work independently and collaboratively within a team environment.
• Minimal travel within California
• Minimal physical activity; may include standing and repetitive motion